MEDICARE: DR. DAVID FINK PFENDLER MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Y00000X	Otolaryngology Physician	9514	OR

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1568466282
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DAVID FINK PFENDLER MD

Provider Business Mailing Address
First Line	:	15410 NW BAKER CREEK RD
Second Line	:
City	:	MCMINNVILLE
State	:	OR
Zip	:	97128-8063
Country	:	US
Telephone Number	:	503-472-4355
Fax Number	:

Provider Business Practice Location Address
First Line	:	15410 NW BAKER CREEK RD
Second Line	:
City	:	MCMINNVILLE
State	:	OR
Zip	:	97128-8063
Country	:	US
Telephone Number	:	503-472-4355
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/09/2005
Last Update Date	:	01/07/2010

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